Department of Food Technology & Nutrition Science, Noakhali Science & Technology University, Bangladesh.
Department of Food Technology & Nutrition Science, Noakhali Science & Technology University, Bangladesh; School of Communication, Hong Kong Baptist University, Hong Kong.
J Pediatr Nurs. 2021 May-Jun;58:e44-e53. doi: 10.1016/j.pedn.2020.12.017. Epub 2021 Jan 23.
Though the benefits of exclusive breastfeeding (EBF) till the age of six months are unanimously perceived and ubiquitously accepted, there are several factors that impede this great practice all over the world, and Bangladesh is no exception.
A clinic-based, mixed-method, cross-sectional study was conducted to investigate the EBF practice and the possible causes of early cessation in Noakhali district, Bangladesh. The Kaplan-Meier survival curve with a log-rank test was used to compare the survival differences of recommended and observed EBF practices. The life table for EBF practice was also presented, and the multivariate cox proportional regression model was used to identify the predictors of EBF duration. Two focus group discussions were conducted to generate qualitative data on EBF cessation.
The mean duration of EBF was five months; only 30% of mothers did not complete EBF, and the cumulative survival curve showed a sharp fall after four months of breastfeeding. However, factors such as mother's advanced age (30 years or above; AHR: 0.376, 90% CI: 0.158-0.893) and low level of education increase the risk of the EBF cessation, while being housewife mothers, preceding birth interval of more than 2 years and living in urban areas decreases the risk of EBF termination. Perceived inadequacy of breast milk and some cultural norms were among the cessation factors revealed in qualitative analysis.
Although the completion rates of EBF practice seem to be high in this study population, some socio-cultural issues remain to be addressed, and further promotional efforts should be made to continue and improve the EBF practice.
尽管人们普遍认识到并普遍接受了纯母乳喂养至 6 个月的益处，但在全球范围内，仍有几个因素阻碍了这一伟大实践，孟加拉国也不例外。
本研究采用基于诊所的混合方法、横断面研究，旨在调查孟加拉国诺阿卡利地区的纯母乳喂养实践情况及早期中断的可能原因。采用 Kaplan-Meier 生存曲线和对数秩检验比较推荐和观察的纯母乳喂养实践的生存差异。还呈现了纯母乳喂养实践的寿命表，并使用多变量 Cox 比例风险回归模型来确定纯母乳喂养持续时间的预测因素。进行了两次焦点小组讨论，以生成有关纯母乳喂养中断的定性数据。
纯母乳喂养的平均持续时间为 5 个月；只有 30%的母亲没有完成纯母乳喂养，累积生存曲线显示母乳喂养四个月后急剧下降。然而，母亲年龄较大（30 岁及以上；AHR：0.376，90%CI：0.158-0.893）和教育水平较低等因素增加了母乳喂养中断的风险，而作为家庭主妇的母亲、生育间隔超过 2 年以及居住在城市地区则降低了母乳喂养终止的风险。在定性分析中发现，母乳不足的认知和一些文化规范是中断的因素之一。
尽管在本研究人群中，纯母乳喂养实践的完成率似乎较高，但仍存在一些社会文化问题需要解决，应进一步开展宣传工作，以继续和改善纯母乳喂养实践。
